Nepali Times
Hope on the hilltop


When he was four, Krishna fell off the window of his house and hurt his knee. The bones inside never healed and he has limped ever since. Krishna is now 16, and his parents brought him to the Hospital and Rehabilitation Centre for Disabled Children (HRDC) at Banepa. Doctors there found that the knee injury had affected the boy's thigh as he grew. Last month, the deformity was corrected by surgery and Krishna wears a special ring fixator to lengthen his short leg. He will soon walk normally.

Like thousands of Nepali children born with clubfeet, Sunita, 11, was told she had the curse of the gods. But Sunita always dreamt of the day she would walk normally. Her dream has nearly come true: after surgery in Banepa, a year or two of physiotherapy and she will be back on her feet again.

Sunita and Krishna are two of thousands of children who, after living with physical deformities for years have a chance now of beginning a new life. And all this thanks to a unique charity for treating disabilities with world-class orthopaedic surgeons-right here in Nepal.

Nearing Banepa on the Arniko Highway, a cluster of elegant tile-roof buildings on a thickly forested hilltop comes into view. From the road, the complex looks more like a five-star resort. Spreading across nine hectares, the hospital at Adhikari Gau is situated in idyllic surroundings, the facilities are clean, bright and airy, functional and well-managed.

The hospital is the brainchild of Nepal's most-famous orthopaedic surgeon, Ashok Banskota, for whom the facility is the realisation of a life-long dream. "In Nepal disability is a problem of the poor, and what we are doing is giving them the best possible care and making that treatment affordable." The hospital is supported by Terre des homes (Tdh), a Swiss charity and grants from even boy and girl scouts in Luxembourg. The construction of the $2.6 million 71-bed hospital was completed in 1997, and inaugurated by the late King Birendra.

After finishing medical school in the United States and specialising in orthopaedics at Johns Hopkins University, Banskota could have stayed on and become a well-off doctor in America. But a sense of giving back to Nepali society what society gave to him brought Banskota home. "It all depends what you want out of life," says the soft-spoken doctor. "The practice in America would have been well-paying but routine. Here I face challenges every day, the need in Nepal is so great that I know that despite everything we have done we are not even scratching the surface."

And Banskota has given this project his heart and soul. And the idea was to build a centre of excellence in orthopaedic surgery, as good as any part of the world, he says Banskota. The hospital has 10 visiting specialists, 120 staffs and a workshop where low-cost orthopaedic devices-from crutches to custom-built shoes-are fabricated.

HRDC also has a way to fulfil its stated promise: no child with disability ever goes back without treatment. The costs are subsidised, and the really poor patients are paid out of funds from an employee contribution kitty.

Statistics on childhood disability in Nepal are sketchy. One estimates says that as many as a quarter of all Nepalis have some form of disability or other, and 30 percent of them are preventable. HRDC's own data from patients offers a clearer picture: 34 percent have congenital disability, in 27 percent it is caused by infections (for example polio), 11 percent by burns and another 11 percent by untreated trauma.

"Every case you get there is a challenge. It is a medical challenge to treat, and it is a social challenge to ensure that those who can't afford it get that treatment, and to make sure that there is followup," says Dr Saroj Rijal who carries out surgery everyday in Banepa. HRDC functions as a referral centre for hospitals across Nepal, and a teaching extension for the Kathmandu University. It also does its own scouting for disabled children through mobile clinics and following up on patients in about 30 districts.

All of that costs money: HDRC's annual budget of Rs 40.5 million comes mainly from charities abroad. The average cost of treating a patient is high (Rs 30,000) because the children need to stay for at least three weeks for physiotherapy and follow-up. "Our major worry is continued funding," admits Krishna Prasad Bhattarai, Director at HRDC. "We've tried to raise money locally, but with little success." Tdh has begun downsizing contributions, which means the hospital would have to generate more money locally each year. At present, the hospital's income is only Rs 6 for every Rs 100 it spends on treatment. There is therefore no option but to take fund-raising into high gear.

But Banskota is optimistic: "We've already accomplished what we thought was impossible, we will find a way out."

(11 JAN 2013 - 17 JAN 2013)